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添加《精神疾病诊断与统计手册》第五版(DSM-5)中躁狂发作的精力/活动增加标准如何改变双相情感障碍的格局?

How Does Adding the DSM-5 Criterion Increased Energy/Activity for Mania Change the Bipolar Landscape?

作者信息

Grunze Anna, Born Christoph, Fredskild Mette U, Grunze Heinz

机构信息

Psychiatrisches Zentrum Nordbaden, Wiesloch, Germany.

Psychiatrie Schwäbisch Hall & PMU, Nuremberg, Germany.

出版信息

Front Psychiatry. 2021 Feb 18;12:638440. doi: 10.3389/fpsyt.2021.638440. eCollection 2021.

Abstract

According to DSM-IV, the criterion (A) for diagnosing hypomanic/manic episodes is mood change (i.e., elevated, expansive or irritable mood). Criterion (A) was redefined in DSM-5 in 2013, adding increased energy/activity in addition to mood change. This paper examines a potential change of prevalence data for bipolar I or II when adding increased energy/activity to the criterion (A) for the diagnosis of hypomania/mania. Own research suggests that the prevalence of manic/hypomanic episodes drops by at least one third when using DSM-5 criteria. Whether this has positive or negative impact on clinical practice and research still needs further evaluation.

摘要

根据《精神疾病诊断与统计手册》第四版(DSM-IV),诊断轻躁狂/躁狂发作的标准(A)是情绪变化(即情绪高涨、夸大或易激惹)。2013年《精神疾病诊断与统计手册》第五版(DSM-5)对标准(A)进行了重新定义,除情绪变化外,还增加了精力/活动增加这一内容。本文探讨了在轻躁狂/躁狂诊断标准(A)中增加精力/活动增加这一内容时,双相I型或II型障碍患病率数据的潜在变化。本人的研究表明,使用DSM-5标准时,躁狂/轻躁狂发作的患病率至少下降三分之一。这对临床实践和研究是有积极还是消极影响仍需进一步评估。

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